How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $776.25 Median $1,258.93 Typical High $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
BCBS Alabama Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $323.59 Median $436.52 Typical High $660.69 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $323.59 | $436.52 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,884.03 Typical High $3,548.13 | Facility | None | $549.54 | $2,884.03 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $616.60 | Professional | None | $295.12 | $309.03 | $616.60 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,265.80 | Facility | None | $758.58 | $1,737.80 | $4,265.80 |
United Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $562.34 | Professional | None | $275.42 | $389.05 | $562.34 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $75.86 |
Where Alabama sits
The same service costs 5.2 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Alabama· 18th of 51
$759
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.